Healthcare Provider Details

I. General information

NPI: 1083020242
Provider Name (Legal Business Name): RIMISAC FAMILY HEALTH NP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14036 170TH ST
JAMAICA NY
11434-4632
US

IV. Provider business mailing address

14036 170TH ST
JAMAICA NY
11434-4632
US

V. Phone/Fax

Practice location:
  • Phone: 347-495-5216
  • Fax:
Mailing address:
  • Phone: 347-495-5216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: DANIELLA CASIMIR
Title or Position: OWNER
Credential: FNP
Phone: 347-495-5216